Maintaining Validity: The Development of the Concept of Trust

Judith E. Hupcey

Abstract

Maintaining validity while moving a concept to a higher level of maturity is a dilemma that faces all qualitative researchers. In this section, research projects related to the concept of trust will be used to illustrate how new studies can be built on previous ones and then all studies integrated to develop a comprehensive model without compromising validity. The multiple stages of inquiry will be elucidated using the strategies of deconstruction, development of a skeletal framework, and scaffolding as described by in the opening section by Morse and Mitcham.

The strategy of deconstruction was used in the initial project (Morse, 2000), which was a multidisciplinary concept analysis to determine the level of conceptual maturity. Once it was determined that trust was not well developed in the context of health care interactions, literature was used as data (Morse, 2000) to advance the concept further for the purposes of concept clarification. Although this began the process of identifying the structural features of the concept, these data left us with many questions, particularly since the trust literature was context bound and thus not easily applied to health care relationships. A skeletal framework was then developed to investigate trust in health care relationships using grounded theory (Hupcey, Penrod, & Morse, 2000). This project also advanced the concept further toward maturity, but some aspects still remained unclear. For example, risk as a precondition for trust as found during the concept clarification was not necessarily seen when trust was applied to health care relationships. The strategy of scaffolding was then used as data collection continued with other types of participants and in different contexts to clarify discrepancies in the data and verify the developing model of the concept of trust in health care interactions (Hupcey, Clark, Hutcheson, & Thompson, in press; Thompson, Hupcey, & Clark, in press). Here, I focus on the process of deconstruction, and briefly describe the development of a skeletal framework and the scaffolding process for this research program related to the concept of trust.